CICU over and done with!

Yes, it's been awhile since I've blogged. I lost my motivation during Peds Anesthesia at CCMC and the Thanksgiving holiday season, but I'll try to provide a quick recap.

CCMC was not a lot more down time than Adult anesthesia at Manchester Hospital. I had to compete for procedures with residents from Pediatrics and Denistry. Two intubations seemed like a good day. And that usually required a lot of running around between rooms. At least I was able to read a fair amount and almost finished the Secrets book for Emergency Medicine. I even learned a few things along the way. All in all though, my dexterity got up to speed on adults. The kids were easy and just helped build muscle memory.

The last week of Peds anesthesia I had my Dad and step mother in town, so that kept things busy; entertaining them and showing them a bit of Hartford. It was a very nice visit, but as with all family visits, a bit chaotic.

That led directly into my CICU rotation at Saint Francis Hospital. After my Internal Medicine rotation there, there was a bit of dread over Call nights and scut. Especially since my first and last nights of the rotation were Call shifts. In the end, I think the rotation was MUCH better than Medicine.

I learned a lot more that is relavent to EM about treating AMIs, CHF, arrhythmias, angina and post PCI patients. The faculty Attendings, Cardiology Fellows, Residents and even several of the non-faculty Attendings were great teachers. It was an order of magnitude better than medicine and debunked a lot of the stereotypes about cardiologists being ornary and demeaning. The nursing staff got on my nerves for the hourly calls through the night about mundane lab values or routine changes in vital signs, but even the Call nights were much better.

An added benefit is that I actually had some time to study on my own. I read some UpToDate articlesNEJM issues and some EM articles. It felt like the scut was reasonable (vs. all encompassing) and educational in short.

A good example is my night on CCU. I arrived at 8am Sunday to a pretty full service. The Saturday crew admitted 5 new patients to our service. We divided the patients up and got progress notes out in reasonable time. Then the Resident (moonlighter) and I transferred four patients off our service and admitted three new patients. This took us through about 8pm. I wasn't feeling great so I grabbed a late dinner and went to sleep instead of studying or watching a movie on my iPhone. I was called couple times through the night from the nursing staff but they were easily handled from my Call room. Things got a little crazy in the morning though. We had two admissions come in shortly before we were supposed to sign out to the day team (the normal CCU team of a Resident and 3-4 Interns). I would have normally stayed on as one of the Interns, but like the moonlighter, I needed to sign out get off to another hospital for my new rotation. By the time we got finished examing the new patients, getting histories, putting in orders and filling out the History & Physicals is was way past signout time.

I arrived at Hartford Hospital around 9am and thankfully the Psychiatry Attendings were understandable. I had a quick introduction and they sent me home to rest up post Call.

Now I'm off to two weeks of Psychiatry. Staring with a crazy day tomorrow. I have three hours of Psych evals, then a meeting regarding my scholarly project on the new EDIS implementation, then four hours of conference lectures, then a meeting on updating our International EM web pages, then swimming at the JCC with the boys, and finally stopping by West Wings for the 'night before' gathering with the following days' interviewees for next year's EM class. Whew!

The last month and a half has continued to reinforce my confidence in selecting Emergency Medicine as a specialty. The money, hours (lifestyle) and daily patient care are the best combination I can think of for me. It feels like a good fit and I'm continually motivated to improve my skills, learn more and provide provide better patient care.

Even the New England winter, thus far, hasn't dampened our spirits. The leaves are down, the frost is on the windshields every morning and we've had to buy some winter clothes (sweaters, coats, slippers, etc.), but the family is settling in well. Becky is excelling at the Hispanic Health Council, the kids are busy with honors classes, swimming and music and we are all getting in better shape. And Christmas is right around the corner...